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What is dementia?
A syndrome due to disease of the brain, usually chronic or progressive, causing disturbance in multiple higher cortical functions.
What are the forms of dementia based on the information provided?
At what age does the prevalence of dementia increase significantly?
The national diagnostic rate for dementia is higher than the benchmark diagnostic rate.
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What is the preferred diagnostic criteria for Alzheimer's Disease?
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What is one of the cognitive decline symptoms of Alzheimer's Disease?
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What percentage of dementia cases is Vascular Dementia associated with?
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Match the following types of dementia with their criteria:
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The prevalence rate for ages 70-80 is approximately _____.
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What are some environmental factors associated with dementia?
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Which statement accurately reflects the characteristics of dementia as defined in the content?
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What is the significance of the prevalence rates provided in the information?
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What do the aetiological subtypes of dementia suggest about the complexity of the disorder?
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Which of the following reflects the national diagnostic rate in relation to the benchmark rate?
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What is a common misinterpretation of the functions disturbed by dementia?
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Which of the following symptoms is NOT a required criterion for diagnosing Dementia with Lewy bodies?
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In the criteria for Vascular Dementia, which of the following statements is INCORRECT regarding the onset of dementia?
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What is the first criterion that must be met for a diagnosis of Frontotemporal Dementia according to the Lund-Manchester Criteria?
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Which characteristic is considered supportive but NOT required for a diagnosis of Dementia with Lewy bodies?
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Which combination of symptoms must be present to confirm the diagnosis of Vascular Dementia?
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What is the minimum number of cognitive areas that must show deficits for a diagnosis of probable Alzheimer's Disease according to the NINCDS/ADRDA criteria?
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Which type of dementia is associated with an intact level of consciousness according to the diagnostic criteria?
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Which of the following percentage distributions represents the highest prevalence of dementia types mentioned?
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According to the WHO, what is a common precursor to cognitive function impairment in dementia?
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Which statement correctly describes the diagnostic criteria for Frontotemporal Dementia?
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Study Notes
Dementia: Definition and Prevalence
- Dementia is a syndrome caused by brain disease, typically chronic or progressive.
- It involves disturbances in multiple higher cortical functions (memory, thinking, orientation, comprehension, calculation, learning, language, judgment).
- Consciousness remains unaffected.
- Cognitive impairment often accompanies (or precedes) deterioration in emotional control, social behavior, or motivation (WHO, 1992).
- Prevalence increases significantly with age: 1 in 1000 (40-65 years), 1 in 50 (65-70 years), 1 in 20 (70-80 years), 1 in 5 (80+ years).
- National diagnostic rate for dementia (July 31, 2022): 62% (benchmark: 66.7%).
Types of Dementia
- Four main types: Alzheimer's disease (AD), Vascular dementia (VaD), Dementia with Lewy bodies (DLB), Frontotemporal dementia (FTD).
- AD accounts for 62% of cases (Dementia UK report, 2007).
- VaD accounts for 17% of cases.
- DLB accounts for 4% of cases.
- FTD and other forms of dementia constitute 10-15% & 2-5% of cases respectively.
- Over 200 subtypes of dementia exist (Haan & Wallace 2005).
Alzheimer's Disease (AD)
- Characterized by gradual progression, intact consciousness, onset after age 40, and no other identifiable cause (NINCDS/ADRDA criteria).
- Shows decline in examination and objective testing across two or more cognitive areas.
- Cognitive decline progresses over time, potentially spanning 4-8 years (or even up to 20 years).
Vascular Dementia (VaD)
- Involves dementia alongside cerebrovascular disease and focal stroke signs.
- Presents with impairment in memory and at least one other cognitive domain.
- Evidence of relevant cardiovascular disease (CVD) is shown through CT/MRI scans.
- Onset may occur within three months of a stroke, or present with abrupt deterioration or fluctuating, stepwise cognitive decline.
Dementia with Lewy Bodies (DLB)
- Features progressive cognitive decline affecting daily functioning.
- Requires two of the following: fluctuating cognition, recurrent visual hallucinations, spontaneous Parkinsonism.
- Supportive diagnostic features include repeated falls, syncope/transient loss of consciousness, neuroleptic sensitivity, paranoid delusions, and hallucinations in other modalities.
Frontotemporal Dementia (FTD)
- Characterized by insidious onset and gradual progression.
- Shows early decline in social interaction, personal conduct regulation, emotional blunting, and insight.
Causes of Dementia
- Biological factors: Genetic predisposition (chromosomes), altered brain pathology.
- Psychosocial factors: Malignant social psychology (intimidation, disempowerment, etc. as described by Kitwood’s model (1997)).
- Environmental factors: Lifestyle (alcohol, smoking, diet), physical environment (floor patterns, lighting, overstimulation).
Kitwood's (1997) Psychological Needs in Dementia Care
- Comfort
- Occupation
- Attachment
- Identity
- Inclusion
Malignant Social Psychology (Kitwood)
- Includes actions detracting from the five key psychological needs mentioned above
Therapeutic Implications
- Focus on prevention (reducing risk factors), slowing progression, and treating symptoms to slow decline.
- Risk factors for dementia include: less education, hypertension, hearing impairment, excessive alcohol consumption, smoking, obesity, depression, traumatic brain injury, physical inactivity, diabetes, low social contact, air pollution.
Slowing Progression
- Focus includes managing acetylcholine levels and vascular problems.
Treating Symptoms
- Addressing cognitive symptoms (memory), behavioral and psychological symptoms (depression, hallucinations, delusions, wandering, vocalizations, aggression).
Dementia: Definition and Prevalence
- Dementia is a syndrome caused by brain disease, typically chronic or progressive.
- It involves impaired higher cortical functions: memory, thinking, orientation, comprehension, calculation, learning, language, and judgment.
- Consciousness remains unaffected.
- Cognitive impairment often accompanies emotional control, social behavior, or motivational deterioration.
- Prevalence increases significantly with age: 1 in 1000 (40-65 years), 1 in 50 (65-70 years), 1 in 20 (70-80 years), and 1 in 5 (80+ years).
- National Diagnostic Rate (July 31, 2022): 62%, Benchmark Diagnostic Rate: 66.7%.
Types of Dementia
- Alzheimer's Disease (AD): Accounts for 62% of dementia cases. Diagnostic criteria include dementia, gradual progression, intact consciousness, onset after age 40, and absence of other causes. Cognitive decline progresses over time through mild, moderate, and severe stages.
- Vascular Dementia (VaD): Criteria include dementia, cerebrovascular disease, focal stroke signs, impairment of memory and at least one other cognitive domain, plus evidence of relevant cerebrovascular disease (CT/MRI). Onset can be abrupt, with fluctuating or stepwise progression.
- Dementia with Lewy Bodies (DLB): Characterized by progressive cognitive decline, plus two of the following: fluctuating cognition, recurrent visual hallucinations, or spontaneous Parkinsonism. Supporting features include falls, syncope, neuroleptic sensitivity, delusions, and hallucinations in other modalities.
- Frontotemporal Dementia (FTD): Defined by insidious onset, gradual progression, early decline in social conduct, impaired personal conduct regulation, emotional blunting, and early insight loss.
Dementia: Memory and Cognitive Aspects
- Memory systems affected include perceptual representation, working memory, semantic memory (facts, knowledge), episodic memory (events, experiences), and procedural memory (motor and cognitive skill learning).
- Different types of dementia affect various cognitive domains with variable severity.
- The frontal lobe is involved in planning, organizing actions, regulating behavior, abstract thought, logic, and language.
- The parietal lobe handles spatial awareness, calculation, and sentence construction.
- The temporal lobe processes memory and visual perception (including color recognition), and the occipital lobe is primarily involved in visual processing.
Dementia: Causes and Risk Factors
- Biological factors: Chromosomes linked to dementia, altered brain pathology.
- Psychosocial factors: "Malignant social psychology" including intimidation, disempowerment, imposition, disruption, infantilisation, stigmatisation, disparagement, ignoring, banishment, mockery, treachery, invalidation.
- Environmental factors: Lifestyle (alcohol, smoking, diet), physical environment (floor patterns, lighting, overstimulation).
Dementia: Care and Therapeutic Implications
- Kitwood's (1997) psychological needs: comfort, occupation, attachment, identity, and inclusion.
- Therapeutic approaches focus on preventing onset, slowing progression, and treating symptoms to slow decline.
- Prevention is emphasized.
Dementia: Subtypes and Diagnostic Criteria
- Over 70, 100, or 200 subtypes have been suggested by different researchers.
- Preferred diagnostic criteria exist for Alzheimer's disease (NINCDS/ADRDA), vascular dementia (NINDS-AIREN), dementia with Lewy bodies (international consensus criteria), and frontotemporal dementia (Lund-Manchester or NINDS criteria).
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Description
This quiz explores the definition and prevalence of dementia, delving into its types and their distinctions. Learn about the significant impact of age on dementia prevalence and familiarize yourself with the four main types of dementia. Test your knowledge on how dementia affects cognitive functions and social behavior.
